ISPOR Global Panel Proposes New Structure to Improve Definitions of Digital Health Interventions

Published Apr 9, 2024

PICOTS-ComTeC Framework Seeks Consistency in Definitions Practices

Lawrenceville, NJ, USA—April 9, 2024—ISPOR—The Professional Society for Health Economics and Outcomes Research announced today the publication of a report from the ISPOR Digital Health Special Interest Group that proposes a new framework to help standardize and clarify definitions used for digital health interventions. The report, “The PICOTS-ComTeC Framework for Defining Digital Health Interventions: An ISPOR Special Interest Group Report” was published in the April 2024 issue of Value in Health.

"Digital health involves technologies including artificial intelligence, virtual reality, digital therapeutics, wearables, remote monitoring, and software," explained author Zsombor Zrubka, PhD, Health Economics Research Center, Óbuda University, Budapest, Hungary, “and we denote these technologies as digital health interventions. Recognizing the terminology limitations in digital health, our goal was to develop a definition framework for patient-facing digital health interventions for health economics and outcomes research purposes, which allows the identification of comparable digital health interventions with similar intended effects. Specifically, to capture relevant aspects of patient-facing digital health interventions, we aimed to extend the PICOTS (Population, Intervention, Comparator, Outcome, Timing and Setting) framework.”

The development of the PICOTS-ComTeC framework involved a systematic review of existing terminology for digital health interventions, content analysis, as well as an international Delphi consensus process. As Zrubka describes, "After reviewing unique definitions of primary and secondary digital health-related terms from over 200 systematic reviews, we found a striking diversity of concepts and lack of important details." This variability highlighted the need for a standardized framework. The core team reviewed and consolidated survey findings, then reorganized consensus items under the proposed PICOTS-ComTeC acronym, where “Com” stands for Communication, “Te” for Technology, and “C” for Context.

PICOTS-ComTeC is a flexible and versatile tool, aimed to help authors in designing and reporting evidence syntheses or research questions with actionable results for clinicians and other decision makers. PICOTS-ComTeC may also help developers and researchers conducting studies on individual digital health interventions to report sufficient detail about the intervention to allow the use of results in evidence syntheses.

“The strength of our research is that PICOTS-ComTeC integrates relevant pieces of digital technology information with the widely recognized PICOTS framework,” noted Zrubka. “PICOTS-ComTeC relies on the consensus of experts with diverse geographic and professional backgrounds. While overlapping with established digital health intervention reporting checklists, PICOTS-ComTeC aims to define digital health interventions in sufficient detail for multiple purposes from a health economics and outcomes research perspective.”

About ISPOR’s Digital Health Special Interest Group
The mission of the Digital Health Special Interest Group is to address new opportunities in the healthcare sector emerging from the increasing use of digital technologies, specifically telemedicine and mobile devices, and to evaluate the impact of information and communication technology on health outcomes. This paper is the second article reporting outputs from the Key Project for the Digital Health Special Interest Group, which has also resulted in numerous posters and presentations. The term "digital health" is extremely broad and can include electronic medical records, electronic health records, telemedicine, mobile health, and wireless health, among others. Utilization of digital health technologies provides opportunities to increase the quality of care and the accuracy of healthcare analytics, and to ensure greater safety owing to the patient follow-up. However, digital health represents a field fraught with challenges within the healthcare market. Not only are there numerous and different ways to classify and define “digital health” and related subtopics, but there is also a lack of methodological approaches available to assess the value of digital health solutions. The usefulness along with the quality and reliability of health information gathered via digital health (eg, mobile apps) must be addressed before one can feel confident of the reliability of digital health solutions and subsequent use by patients and researchers for assessing the value of healthcare interventions. Click here to learn more.


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ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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Value in Health
(ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s 2022 impact factor score is 4.5 and its 5-year impact factor score is 6.2. Value in Health is ranked 8th of 87 journals in health policy and services, 21st of 105 journals in healthcare sciences and services, and 69th of 380 journals in economics. Value in Health is a monthly publication that circulates to more than 10,000 readers around the world.
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